超声评分法评价胎儿单侧肾盂分离预后的价值  

Clinical value of ultrasonography score in evaluation of prognosis of unilateral fetal hydronephrosis

作　　者：贾保霞[1] 刘宇清[1] 刘滨月[1] 周富强[1] 陈金华[1] 黄雪兰[1] 

机构地区：[1]广东省深圳市龙岗中心医院超声科,深圳518116

出　　处：《山西医科大学学报》2013年第6期479-483,共5页Journal of Shanxi Medical University

基　　金：广东省深圳市龙岗区医疗卫生科技计划基金资助项目(YLL2010054)

摘　　要：目的探讨超声评分法评价胎儿单侧肾盂分离的预后价值。方法对孕期发现的单侧肾盂分离的39例胎儿,应用彩色多普勒超声测定并记录肾盂分离侧的肾盂前后径(APD)、肾实质厚度、肾盏形态并分别赋予0-3分,累计每只肾的积分。根据随访结果将胎儿肾积水分为生理性肾积水和病理性肾积水。绘出各单因素及超声评分法的ROC曲线并进行配对比较。结果①39例单侧肾盂分离胎儿,10例为可复性肾盂分离,29例为不可复性肾盂分离。②超声评分法和APD、肾实质厚度、肾盏形态评价胎儿肾盂分离情况的4条ROC曲线下面积分别为0.971,0.864,0.903,0.947。经Z检验,超声评分的曲线下面积均大于各单因素的面积(P<0.05)。③超声评分法以6分为诊断病理性肾积水最佳截断值,灵敏性82%,特异性90%。结论超声评分法比APD、肾实质厚度、肾盏形态各单因素能更有效评价胎儿单侧肾盂分离的预后,可用以临床鉴别胎儿单侧生理性与病理性肾积水。Abstract： Objective To explore the significance of ultrasonography score in the evaluation of fetal unilateral hydronephrosis.Methods Altogether 39 fetus with hydronephrosis at pregnant period were collected.Anteroposterior diameter（APD）,renal parenchyma thickness and the dilatation of renal calices were measured,and then an ultrasonography score was graded from 0 to 3 scores based on the severity of hydronephrosis.The total ultrasonography score of every kidney was accumulated and compared with the follow-up results.According to the follow-up results,all cases were divided into two groups：physiological and pathological hydronephrosis.The predictive value of every factor and ultrasonography score for hydronephrosis was compared by making ROC curves.Results ①Confirmed by postanatal ultrasound and other clinical examinations,10 of 39 kidneys were diagnosed as physiological hydronephrosis and 29 were pathological hydronephrosis.②AUC （area under the curve） of ultrasonography score,APD,renal parenchyma thickness and the dilatation of renal calices was 0.971,0.864,0.903 and 0.947,respectively.The AUC of ultrasonography score was significantly higher than those of the other three single factors（P 〈 0.05）.③The best cut-off value of the ultrasonography score was 6 scores and its corresponding sensitivity and specificity was 82% and 90%,respectively.Conclusion The ultrasonography score can more effectively evaluate the prognosis of fetal hydronephrosis than the other three single factors,and it can clinically differentiate the physiological from pathological hydronephrosis.

关 键 词：超声评分法 胎儿 单侧肾盂分离 

分 类 号：R445[医药卫生—影像医学与核医学]